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Individual

MRS. LORRI M PETTERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
863 NE HIDDEN VALLEY DR UNIT 1, BEND, OR 97701-6575
(541) 350-3945
Mailing address
863 NE HIDDEN VALLEY DR UNIT 1, BEND, OR 97701-6575
(541) 350-3945

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
200941831
OR
164W00000X
Licensed Practical Nurse
200830291
OR

Other

Enumeration date
02/10/2010
Last updated
02/10/2010
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